Reproductive Politics

REPRODUCTIVE POLICIES OUTSIDE THE UNITED STATES

Reproductive politics address fundamental values relating to highly personal topics, such as sexuality, marriage, bodily integrity, and the definition of life. Specific topics addressed are drawn from the steps in human reproduction (sexual intercourse, conception, gestation, and parturition) as well as the major interventions in fertility control (abstinence, contraception, and induced abortion). Because only women become pregnant and bear children, reproductive politics necessarily reflect attitudes and social mores about the role of women. While reproductive politics in the United States became particularly fierce after the 1973 Roe v. Wade decision, the state’s role in reproductive behavior has been debated for considerably longer.

At the beginning of the nineteenth century, reproductive matters were largely outside of American politics, but contraception and induced abortion were legal. Puritan disapproval of birth control as well as other social conventions kept these subjects out of the realm of politics. By the end of the century, both contraceptive practice and induced abortion had been outlawed in every state. Physicians led the way in passing state anti-abortion legislation, but opposed contraceptive restrictions. In 1873, Congress passed the Act for the Suppression of Trade in and Circulation of, Obscene Literature and Articles of Immoral Use. Known as the Comstock law, the act prohibited interstate trading in any article that prevented conception or caused abortion. Twenty-two states followed with even more contraceptive restrictions, called the “little Comstock laws.”

Removing nineteenth-century prohibitions was a major part of reproductive politics during much of the twentieth century. The most influential birth control crusader was Margaret Sanger, founder of the American Birth Control League, which eventually became Planned Parenthood Federation of America. By 1937, the birth control movement had orchestrated and won the U.S. v. One Package case, which largely invalidated the federal Comstock law. It was 1965, however, before the U.S. Supreme Court overturned Connecticut’s Comstock law prohibiting the use of birth control by even married couples (Griswold v. Connecticut ) and 1972 before the Court invalidated the Massachusetts law specifically prohibiting unmarried persons from obtaining contraceptives (Eisenstadt v. Baird ). In the 1973 Roe v. Wade decision, the Court legalized abortion.

Roe v. Wade ignited interest group activity in reproductive politics. There are many advocacy groups in this arena, including the NARAL Pro Choice America (pro-choice or favoring the legal status of abortion) and National Right to Life (pro-life or opposing the legal status of abortion). Their debates have expanded far beyond the legal status of abortion and now focus on policies toward welfare, scientific research, custody of offspring, international humanitarian assistance, and a variety of other subjects. These topics are best framed within steps in reproduction.

STEPS IN REPRODUCTION

Except for artificial insemination and in vitro fertilization, the first step in human reproduction is sexual intercourse. Within reproductive politics, who should be sexually active and with whom are active debates. Religious conservatives believe that heterosexual marriage is the only suitable context for sexual activity; their growing political involvement has spawned significant federal support for abstinence-only education and the ABC (Abstain, Be faithful, or use Condoms if you cannot follow A or B) policy in HIV/AIDS prevention. Opposing groups argue for accurate, comprehensive sex education that includes contraceptive information, pointing out that the effectiveness of abstinence-only education has not been demonstrated and that most people are sexually active years before marriage.

Conception is the second step in human reproduction. The politics regarding it include both contraception and fertilization. Here there are differing viewpoints concerning who should have access to birth control, what methods are appropriate, and how to pay for contraceptives. The provision of contraception to minors is hotly debated, particularly whether there should be mandated parental involvement (e.g., permission or notification). The politics around available methods includes the U.S. Food and Drug Administration (such as delays in the approval of over-the-counter emergency contraception) and product liability laws, which have limited contraceptive options in the United States. Political issues around fertilization include who should have access to assisted fertility technology (such as single women, married heterosexual couples, persons under a certain age) and how fertilized eggs can be used (for example, stem cell research and embryo adoption).

The third step in human reproduction is gestation and parturition. The dominant issue here is induced abortion or pregnancy termination. Abortion brings up a number of policy issues such as parental involvement, mandatory waiting periods, informed consent, funding, allowable procedures (such as partial birth abortion, which is a political term from the Christian Coalition, not a specific medical procedure) pharmaceutical abortifacients, and gestational limits. Many of these policies vary widely among the states.

Other political issues related to gestation include violence against pregnant women; the Mexico City policy, also known as the Global Gag Rule; surrogate maternity; and drug use and pregnancy. For example, the Unborn Victims of Violence Act, enacted in 2004, known as the “Laci and Conner Law,” establishes the same penalty for killing a fetus in utero as for killing a pregnant woman. Both sides in the abortion debate have seen this legislation as a step toward criminalizing abortion. The Mexico City policy forbids foreign nongovernmental organizations that are recipients of American population assistance from referring their patients for abortions or from engaging in political activity to legalize abortion in their countries.

Advances in technology have brought many new questions, including who should pay for in vitro fertilization, who is able to benefit from this technology, whether children conceived with donated sperm or ova have the right to know their biological origins, and whether embryos can be created for research purposes. In human reproduction, science has raced far ahead of policy. All of these issues and many more will be decided within the rubric of reproductive politics.

Since Roe v. Wade, the coalitions in this policy arena have been fairly consistent, and they have become more partisan. Pro-choice groups tend to line up with other groups supporting access to contraception and comprehensive sex education. Pro-life groups tend to support abstinence-only education as well as legally mandated parental involvement in both contraceptive and abortion decisions. Several prominent scholars think that these divisions are based on beliefs about the role of women. Although there are individual exceptions, the Democratic Party generally reflects the pro-choice positions, and the Republican Party espouses the pro-life position. Advances in reproductive technology, however, sometimes alter these coalitions; the stem cell controversy within the Republican Party is an example of such a development.

REPRODUCTIVE POLICIES OUTSIDE THE UNITED STATES

Although American reproductive politics are particularly contentious, public debates about reproductive issues are certainly not confined to the United States. Issues that achieve prominence vary by region and culture. In western Europe, for example, adolescent sexual activity is generally a subject for public debate. Public health policies support widespread contraceptive availability. Consequently, western European abortion rates are a small fraction of those in the United States. Moreover, abortion politics are not as nearly as vociferous.

Low fertility is a concern in much of Europe and Japan. Public policies to increase childbearing have had mixed results. Generous French maternity leave and childcare policies, however, have apparently achieved their pronatalist objectives, and recently the Japanese birth rate has increased slightly.

In much of the world, reducing fertility rates is still on the public agenda. China retains its one-child policy, instituted in 1979, although the impact of that measure on fertility has been debated. Moreover, the one-child policy has skewed the ratio of males to females in that nation. As birth rates decrease in Latin America, politics in that region are focusing more upon maternal health measures such as legal access to emergency contraception and safe abortion.

As a continent, Africa has the highest fertility rates in the world as well as some of the highest maternal mortality ratios due to the unavailability of contraception, female genital mutilation, and unsafe abortion. Because of the low status of women in many African countries, these issues have not been salient until the mid-2000s. The HIV/AIDS epidemic has put reproductive politics on the public agenda in several African nations.

SEE ALSO Roe v. Wade; Abortion; Birth Control; Fertility, Human; Infertility Drugs, Psychosocial Issues; Politics: Gay, Lesbian, Transgender, and Bisexual; Politics, Gender; Pro-Choice/Pro-Life

BIBLIOGRAPHY

Hesketh, Therese, Li Lu, and Zhu Wei Xing. 2005. The Effect of China’s One Child Family After 25 Years. New England Journal of Medicine 353 (11): 1171-1176.

Kulczycki, Andrzej. 1999. The Abortion Debate in the World Arena. New York: Routledge.

McFarlane, Deborah R. 2006. Reproductive Health Policies in President Bush’s Second Term: Old Battles and New Fronts in the United States and Internationally. Journal of Public Health Policy 27 (4): 405-426.

Population Reference Bureau. 2004. Transitions in World Population (Population Bulletin 59:1). Washington, DC: Population Reference Bureau. http://www.prb.org/Template.cfm?Section=Population_Bulletin1&Template=/PopulationBulletin2.cfm.

Deborah R. McFarlane